The creation of the “S3 Guideline Vaginal Birth at Term” is a milestone in the recognition of birth as a physiological life experience for women and mothers.
We would like to thank all those involved. Nevertheless, a careful revision is urgently required following the evaluation of our survey.
We would particularly like to emphasize that, in addition to considering external and internal evidence, the rights, wishes and preferences of pregnant women, women giving birth, newborns and their families are given special consideration.
Birth is a hormone-controlled, individual physiological process that depends on the woman's environment and state of health.
Peace and quiet, the opportunity for intimacy and security, friendly support and safety from the beginning of the pregnancy, both clinically and non-clinically, are fundamental prerequisites for this.
During pregnancy, gynecologists and midwives should provide binding information about the conditions for the body's own hormone production (oxytocin, endorphin, adrenaline and many more).
Rooms close to the clinic and their sensitive architectural design can meet the needs of the mother and her companion and have a positive effect.
Basic time specifications for individual stages of labor contradict the requirement to provide woman-centered support and should be omitted.
The revised guideline should emphasize the individual time factor for the development of labour and provide information on the conditions for the body's own endorphin development.
Children's rights as defined by the UN Convention on the Rights of the Child must be observed (Source 22).
Reducing intervention rates has the effect of reducing iatrogenic (medically induced) risks. Hospital births can benefit overall if time is no longer a factor in favor of “skillful waiting”. This applies both to the attitude of the staff and to the structural requirements.
The results of the “Be-up: Geburt aktiv” study should be more than just a call to action for all delivery rooms. Regular further training in line with the new guideline should be a prerequisite for obstetric teams to open and maintain obstetric departments.
Injury to the woman through an episiotomy poses a high risk to her sexual health. Pregnant women should be informed that the perineum stretches naturally through movement, changing birthing positions, sufficient time and the body's own hormones. This protects the perineum.
We call for a restrictive approach, only for the benefit of the child or at the express wish of the woman. This should be discussed when registering at a clinic. Midwives and doctors should also make this aspect a compulsory part of antenatal care.
The importance of comprehensive birth preparation should be clearly stated.
The large number of uninformed women and mothers on the subject of the Kristeller handle is very worrying. Various injuries to the child and mother are possible and have been proven. In our opinion, comprehensive information about this medical intervention should be part of every pregnancy and every antenatal course.
It is recognized that separation and interruption of bonding after birth are detrimental to bonding development. Maintaining awareness of this and providing training in this area should be a mandatory part of further training for obstetric professionals.
Baby-friendly obstetrics is not a “nice to have”, but a basic requirement.
The maternity record is the property of the mother and serves to support and inform her pregnancy. Sensitive, respectful and comprehensible treatment by documenting midwives and doctors is a matter of course.
However, the documentation rate of 38% high-risk pregnancies in the maternity record is an indication of problematic handling.
The distinction between prenatal care and prenatal diagnostics should also be much clearer, e.g. through colored pages.
We parents' initiatives would like to see an attitude in which being pregnant is valued beyond monetary interests.
We appeal to the Commission to set the course for further improving the conditions for a physiological birth experience by revising the “S3 guideline on vaginal birth at term”.
In doing so, we would like to make clear reference to the guaranteed human rights of women and children.
The editors
Translated with DeepL.com